P - 79840' REQUEST FOR ELECTRICAL INSPECTION
° Minnesota Board of Electricity �
1� 3 O 0� 0 0 0 � s 1821 University Avenue Suite S-128, Saint Paul, Minnesota 55104
� � � (651) 642-0800 TTY/M RS 1-800-627-3529
www. electricity.styte:mn^.'efs
Identify the work covered by this request:
❑NEW ❑REMODEL ❑ADDITION PP
GENERAL F ES
SERVICES / POWER SUPPLIES
0 to 400 Am re �$25
401 to 800 Am re�$50
Above 800 Am ere � $75
CIRCUITS / FEEDERS
0 to 200 Am ere �$5
Above 200 Am re � $10
ALARM, COMMUNICATION, REMOTE CONTROL,
CIRCUITS, GIRCUITS OF LESS THAN 50 VOLTS
Each S stem Device or A ratus �$.50
ADDITIONS TO THE GENERAL F
Each Addidonal UnR � $25
OTHER ADDITIONAL
Lighting Retrofit � $.25 per Fi�Rure
Center Pivot Irrigation Boom � $40
Manufactured Home Park Lots � $25
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Traffic Si nal Standard � $5
Su plemental Fee � $20 .
Transformers u to 10 KVA �$10
Transformers over 10 KVA � $20
Transformer / Power Su i for Si ns / Outline Li htin �$5
ONE & TWO FAMILY DWELLINGS, EACH UNIT
Includes the Service and�or Power Supply up to 500 Amperes, All
Circuits and Two Inspection Trips Each Dwellin Unit �$8(
Additional Ins ection Tri s�$20
Investi ative Fee
Reinsoection Fee � $20
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S ecial Ins ection �$30 r Hour r°°""""'""
Speciai Inspection � $.31 per Mile �
� THIS INSTALLATION MAY BE ORDE ONNECTE
FOR OFF�E USE ONLY
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total fee is
I inspecl� the eleciripl installalion descr�ed herein ai the dates stated:
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o�h
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F NOT COMPLETED WITHIN 18 MONTHS
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Request Date: Rough-in Inspection Required? ❑ Yes Inspectfon Other Than Rough-In: IS�Ready Now U wi11 call (
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���� You must call the inspector wRen readyl Date Ready:
I certily that I am th ICENSED CONTRACTOR ❑ COMPANY ❑ OWNER and hereby request inspection of �e electrical wak at